NHANES analysis links lower socioeconomic status with higher self-reported arthritis prevalence

A repeated cross-sectional analysis of National Health and Nutrition Examination Survey data from 1999–2023 found that self-reported arthritis was more prevalent among U.S. adults with lower educational attainment and lower poverty income ratios. The study included 66,314 adults aged 20 years or older with known arthritis status. Because the survey relied on participants’ reports of whether a doctor or other health professional had ever told them that they had arthritis, the results describe measured prevalence and socioeconomic associations rather than evidence that socioeconomic status causes arthritis.

After age adjustment, pooled arthritis prevalence across the survey cycles was 25.8% among adults with less than a high school education, with a 95% confidence interval of 24.9% to 26.7%, compared with 20.0% among college graduates, with a 95% CI of 19.3% to 20.8%. The trend across ordered education categories was significant, with P for trend below 0.001. A similar graded pattern appeared by income: age-adjusted prevalence was 27.8% among adults in the lowest poverty income ratio category, below 1.30; 24.5% among those in the 1.30 to below 3.50 category; and 21.7% among those at or above 3.50. Each estimate included a 95% CI, and the trend across income categories also had P for trend below 0.001.

Age-adjusted prevalence of overall self-reported arthritis increased modestly over the study period, from 21.7% in 1999–2000 to 24.3% in 2021–2023, with P for trend of 0.033. The change in individual arthritis subtypes was not uniform. Osteoarthritis prevalence increased from 6.1% to 12.1% over the same period, with P for trend below 0.001. Rheumatoid arthritis prevalence was comparatively stable, changing from 5.6% to 4.1%, although the trend was not statistically significant, with P for trend of 0.246. Unspecified arthritis declined from 9.4% to 4.7%, with P for trend below 0.001.

Across the pooled socioeconomic strata, rheumatoid arthritis and unspecified arthritis tended to be more prevalent in lower-status groups, while osteoarthritis was more prevalent in groups with greater socioeconomic advantage. The analysis examined education and poverty income ratio as socioeconomic indicators, incorporated survey weights, strata and primary sampling units, and emphasized age-adjusted estimates. It also performed multiple imputation for missing education and poverty income ratio values as a sensitivity analysis. Psoriatic arthritis was available from the 2009–2010 survey onward, rather than for the full 1999–2023 series. The reported evidence is limited to survey-based, self-reported diagnoses and cannot determine whether socioeconomic differences reflect underlying disease patterns, differences in diagnosis or reporting, or other factors. The research was a repeated cross-sectional observational study, not an intervention or a longitudinal test of causation, and the supplied evidence consists of the study abstract rather than the full article and its detailed limitation analysis.

Subject of Research: Socioeconomic differences in self-reported arthritis and arthritis subtype prevalence among U.S. adults

Article Title: Socioeconomic disparities in self-reported arthritis and arthritis subtype prevalence among U.S. adults

Article References: Zhao, W.-Q., Li, X.-S., Shen, S.-C., Wu, C.-L., Huang, J.-F., & Zhu, Y.-H. (2026). Socioeconomic disparities in self-reported arthritis and arthritis subtype prevalence among U.S. adults. BMC Public Health. https://doi.org/10.1186/s12889-026-29912-7

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29912-7

Keywords: arthritis, socioeconomic disparities, NHANES, U.S. adults, osteoarthritis, rheumatoid arthritis, psoriatic arthritis, prevalence, education, income, Socioeconomic, disparities